How Effective Is Birth Control? Know Your Contraceptive Options!

How much do you really know about your birth control options? Which forms are the most effective?

You go to the doctor and we tell you “use condoms every time you have sex!” Then we provide you with the small, yet highly relevant disclaimer, “but they’re not a guarantee against pregnancy so you should use another form of birth control.”

If condoms aren’t a guarantee, what is?

Reversible birth control options vary in effectiveness and fall into two main categories, hormonal and non-hormonal. Let’s go through your options!

Short-term, reversible birth control

The pill

The pill is oral contraceptive that you take every day at the same time.

This is what most doctors talk about first because it is a good short-term option for patients that are reliable at taking medicine every day. When taken appropriately, the pill has a 91% chance of preventing pregnancy. Also, if you’re looking to get pregnant, stop taking the pill and you can get pregnant as soon as your next cycle.

Extended-cycle pills

Extended-cycle pills are a great option and are taken the same as the pill. With a 91% chance of preventing pregnancy, they’re equally as effective. However, with extended-cycle pills, you will only get your period once every 3 months!

The patch

The patch is a form of birth control that is placed on a different area of your skin, for a week at a time, three weeks in a row. However, it’s important to note that you should not use the patch during the week that you are on your period.

Also, the patch is effective 91% of the time and, if you want to get pregnant, you can stop the patch at any time.

The NuvaRing is a small, plastic ring that you insert into your vagina to provide birth control. It’s designed to use one ring over a period of 3 consecutive weeks. Upon the start of the fourth week, the week of your period, it must be taken out.

The NuvaRing is effective 91% of the time and, if you want to get pregnant, you can stop it at any time.

Diaphragm

Combined with spermicide, diaphragms are about 88% effective. If you’re looking to get pregnant, stop using the diaphragm.

Depo-Provera injections

Depo-Provera is a birth control shot containing the hormone Progestin. This hormone thickens the mucus that lives on your cervix, trapping and blocking sperm from getting in. The shot is given every 3 months, although some providers recommend every 11 weeks so you don’t miss a day by accident.

Each injection has a few major side effects, including irregular menses and weight gain. Experiencing too much weight gain puts you at risk for other medical conditions, so many providers don’t recommend it.

The hardest part about Depo-Provera injections is that after stopping them it can take up to a year to regulate your cycle again for pregnancy. With this in mind, it is 94% effective against pregnancy and is a good temporary long-term option, especially immediately after delivery.

Long-term, reversible birth control

Now, let’s chat about long-acting reversible contraception. These should be your new favorite words. These are options are intended for women that are not planning for pregnancy at this time, but do not want to permanently sterilize with surgical options.

A Nexplanon implant is a 4 cm long rod and is about the size of a match. It’s inserted in your non-dominant arm about 8-12 cm above your elbow between your bicep and tricep muscles, yet just below the skin so you can feel it!

It releases progestin, the same hormone in Depo-Provera, that thickens your cervical mucus to prevent egg fertilization. It can also stop ovulation (i.e. when you release an egg from your ovary). If there’s no egg for sperm to fertilize, there’s no pregnancy. Keep in mind that the hormone released is known to cause spotting or breakthrough bleeding for the first 6 months after insertion.

Also, it lasts for 3 years and is 99% effective against pregnancy.

Intrauterine devices (IUDs)

Last but certainly not least there are 2 types of IUDs, hormonal and non-hormonal. These are small, “T” shaped devices that are inserted through your vagina and cervix into your uterus. Just like the Nexplanon implant, IUDs are 99% effective at preventing pregnancy.

Mirena, Skyla, Kyleena, and Liletta are the 4 FDA approved hormonal IUD options in the US. Just like the Nexplanon implant, they use the hormone Progestin and are known to have spotting during the first 6 months after insertion. Depending on which device you use, they can last for 3-6 years.

On the other hand, the non-hormonal IUD is called Paragard or the “Copper T”. The copper inside this IUD prevents sperm from reaching the egg to fertilize. The Paragard IUD lasts for 10 years and is known to cause heavy menses. Therefore, many people choose one of the hormonal options instead.

Dr. Shannon Carroll was raised in Baltimore, MD where she attended Maryvale Preparatory School. She graduated from Clemson University with a Bachelor of Science in Health Science in 2009. She has worked in Endocrinology, Weight Loss & Management at the Greater Baltimore Medical Center. She attended William Carey University College of Osteopathic Medicine where she graduated with a Doctor of Osteopathic Medicine degree in 2015. She is currently completing her Family Medicine Residency as chief resident at Nassau University Medical Center in Long Island, NY. She practices in all areas of primary care, but takes special interest in Sports Medicine and Emergency/Urgent Care.
Outside of work, she loves to spend time with family and friends, staying active and exploring NYC on the weekends, and traveling anywhere a plane can fly for vacation!